Deaths associated with snow skiing in Colorado 1980-1981 to 2000-2001 ski seasons

Objectives: To investigate the trend and injury patterns of deaths associated with snow skiing in Colorado between 1980 and 2001.

Methods: Death certificates were searched electronically and reviewed manually. Total skier ticket sales were used to calculate death rates. Types of injuries and characteristics of those who died were investigated.

Results: A total of 274 skier deaths occurred between 1980 and 2001 in Colorado. Death rates ranged from 0.53 to 1.88 per million skier visits. The majority of deaths were among males (>81%). Ages ranged from 7 to 77 years with an average of 32 years. The greatest number of deaths associated with downhill skiing (76 deaths) occurred between 10:00 a.m. and 2:00 p.m. while the greatest number of deaths associated with cross-country skiing happened between 2:00 and 6:00 p.m. About 65% of deaths associated with downhill skiing (133 cases) died of traumatic injuries resulting from collisions.

Conclusions: A slight increase in the rate of ski-related deaths was observed. The role of collisions in ski-related deaths warrants further investigation to reduce the risk of this activity for all skiers. Further work is needed to determine the efficacy of helmet use to reduce the risk of head injuries in the skiing population.     

Unintentional injury death rates in rural Appalachia

Rural unintentional injury (UI) death rates are higher than rates for urban regions. Our trauma center serves 49 rural Appalachian (AP) counties in a 120-county rural state. We investigated the impact of prehospital and hospital resources on UI death rates in our referral area. Age-adjusted and average age- and sex-specific UI death rates from 1979-1985 were compared among 49 rural AP counties, the 71 non-Appalachian (NAP) counties, and the United States. Counties were grouped for comparisons by level of prehospital care (Advanced Life Support [ALS] vs. Basic Life Support [BLS]) and by presence (H) or absence (NH) of a hospital. Death rates were calculated using data from the 1980 population census, the National Center for Health Statistics (NCHS), and state vital statistics. Within AP, all 49 counties have ambulance service. Only 9/49 (18%) have ALS service and 13/49 (26%) have no hospital. Age-specific AP rates were higher than NAP and US rates in the 25-44 and 45-64 year age groups. AP death rates were highest for BLS and NH counties across all age groups. Rural UI death rates in the region remain unacceptably high. The reason(s) that AP death rates exceed the NAP rates is uncertain. ALS service and an available hospital were associated with lower death rates. We propose both educational and epidemiologic programs to better identify and define additional problems.     

Reported frequency of dairy farm-associated health hazards, Otsego County, New York, 1982-1983

We surveyed a self-selected sample of dairy farm owners/residents to determine the feasibility of establishing a surveillance system that would identify health risks common to this type of farming activity. Data obtained included demographic characteristics of the farm families, number of milk cows, prevalence of selected respiratory diseases, and farm-related injuries among farm owners. Despite a low overall response rate (45 percent), farm owners/residents reported a higher prevalence of respiratory conditions than that of the United States as a whole. Male farm owners were less likely to smoke than U.S. white males as a whole. The number of farm owners reporting farm-related injuries during a one-year period (9 percent) was similar to previous reports.     

Comparison of urban and rural non-fatal injury: the results of a statewide survey.

OBJECTIVES: This study compared the epidemiology of non-fatal injury among urban and rural residents of Colorado. DESIGN: A stratified probability sample with random digit dial methods was used to survey Colorado residents by telephone regarding injuries experienced in the last 12 months. Questions on the cause of the injury, the activity at the time of the injury, and the place of injury were based on the Nordic Medico Statistical Committee's (NOMESCO) classification of external causes of injuries. SUBJECTS: A total of 1425 urban and 1275 rural Colorado residents aged 18 and older were interviewed. RESULTS: Age, gender, marital status, and rural residency were found to increase the odds of self reported injury. The adjusted odds ratio for self reported injury was 1.3 (95% confidence interval (CI) 1.01 to 1.68) for rural compared with urban residents. Rural residence (odds ratio 1.02, 95% CI 0.51 to 7.01) was not a risk factor for injury among the highest risk group, those who were single and never married. No differences in injury characteristics were found by urban-rural status. CONCLUSIONS: The increased odds of self reported injury among rural residents were not explained by differences in the causes of injury or other injury characteristics. The differences in the importance of rural residence in increased odds of injury by marital status warrants further understanding and may be important in the development of injury prevention programs. Based on comparison with a similar survey, the NOMESCO coding system appears to be a viable alternative survey tool for gathering information on injury characteristics.     

Development of a life events/icon calendar questionnaire to ascertain occupational histories and other characteristics of migrant farmworkers.

BACKGROUND: Specialized methods are necessary to collect data from migrant farmworkers for epidemiologic research. METHODS: We developed a questionnaire that collected lifetime occupational histories and other lifestyle risk factors via a life events/icon calendar, and administered the questionnaire to a convenience sample of 162 migrant farmworkers in nine areas of the U.S. RESULTS: The average duration of the interviews was about 1 h 30 min, with an average of 45 min for the work history section. The occupational histories covered a median of 27.6 years per person for men and 20.8 years per person for women. The median number of years spent in farm jobs was 11.3 for men and 5.8 for women. The median number of farm jobs (crop/task combination) per person was 59 among men and 27 among women. Many farmworkers performed the same crop/task combinations at multiple times throughout their lives, yielding a median of 13 unique farm jobs and 8 unique crops among men and 7 jobs and 5 crops among women. CONCLUSIONS: The project demonstrated that it is feasible to collect detailed work histories and other risk factor data from farmworkers, documented the complexity of work histories encountered among farmworkers, and yielded recommendations for refining a questionnaire that will facilitate future epidemiologic research on farmworkers.     

Suicide and occupation in New Zealand, 2001-2005

Emerging evidence for the role of occupation in suicide risk prompted this analysis. All suicide records in New Zealand between 2001 and 2005 were reviewed. Age- and sex-adjusted suicide rates were calculated for nine major occupational groups. Rates for those not in paid work were adjusted for sex only. A total of 2,024 suicide cases were reviewed. People engaged in paid work had one-fourth of the suicide rate of the non-waged (p < 0.005). Those working in farming, fisheries, or forestry and trades had higher suicide rates than people in other occupations. Homemakers and people with office jobs had the lowest suicide rates. Occupation influenced suicide rates. The continuing disparity in suicide rates between non-waged and waged workers is of particular concern and needs to be addressed. Farmers and trades workers should be monitored more closely.